The arthritis action plan: attitude matters

• For people with chronic health problems, every single day presents a series of complex challenges.
• Even as they cope with their specific condition medically and surgically, these people face tremendous uncertainty regarding the course of their disease and its impact on their lives.
• Add all these burdens to the pain and disability caused by the chronic illness itself and patients can become frustrated and depressed.
• Clearly, the key ingredient in managing a chronic condition is the patient's own involvement in making the decisions about his or her care.
• This need for patients to participate in their own health care may seem obvious now. But until recently, most patients with chronic health problems took a back-seat approach to treatment.
• They went to the doctor to find out how they were doing and rarely asked questions.
• If a drug wasn't helping or was causing adverse effects, they would rarely complain: after all, who were they to question the doctor's wisdom or to judge whether a treatment was working?

You may be familiar with Norman Vincent Peale's book, The Power of Positive Thinking. The take-charge approach emphasizes something similar: the power of a positive attitude. Studies have shown that when people adopt a take-charge attitude toward their arthritis, this itself can do wonders for their pain and disability.

Stay the course.

• This approach was emphasized in the Arthritis Self-Management Program developed by Stanford University in 1979.
• The US Arthritis Foundation adopted the program in 1984 for its arthritis self-help course.
• And the Arthritis Society has helped literally thousands of Canadian arthritis sufferers with its Arthritis Self-Management Program.
• And we're not alone; many countries have used the Stanford-developed program as the basis for their own arthritis self-help programs.
• Numerous studies have evaluated the success of self-management courses in improving the health of arthritis patients.
• In doing their follow-up studies, researchers had expected that the behaviours taught in the course — exercising more and eating healthier, for example — would have the biggest impact on improving participants' health. But the experts made a surprising finding.

Learned optimism.

• Participants had indeed changed their behaviour for the better after taking the course and they experienced significantly less pain and disability compared with patients who hadn't enrolled.
• But their improved health did not flow primarily from the behaviour changes they'd made.
• Instead, the researchers found, participants' success in regaining their health hinged mainly on something else they got from the course: the confidence that they were able to control their arthritis symptoms.
• A take-charge attitude, it turns out, can be learned — and is the key ingredient for overcoming arthritis.